Ewing, who plays Dylan on the hit comedy Modern Family, opened up about how he obsessed over his looks in a recent op-ed piece in the Huffington Post. He says that he has faced eating disorders, depression and body dysmorphic disorder, a condition he describes as a “mental illness in which a person obsesses over the way he or she looks.”

Reid said that he would take pictures of himself, analyzing his looks, before deciding he needed plastic surgery. He said he felt ugly and that his looks were unacceptable.

Reid describes in great detail the horrible pain he went through during his initial surgery, cheek implants and yet felt the need to do it again. He says that no one gave him a mental evaluation, except to ask if he suffered from depression (he did), to learn of his history of eating disorders.

Joy Crabtree, PsyD., a psychologist at Cook Children’s, says that the insecurity and body dysmorphia often develops during adolescence, and they become more unhappy as they get older. In some situations, the discontent may develop in childhood, and start with a specific dislike for a certain part of their body or over focus on a perceived flaw.

“I like how the article makes the point that therapy is a great place to start before jumping into big cosmetic surgery decisions,” Crabtree said. “I think standard protocol requires some level of psychological screening for most bariatric surgeries as well.”

Crabtree says people sometimes don't think of boys dealing with these body image issue, but she treats boys struggling with eating disorders and their own looks.

One in 10 of those diagnosed with eating disorders are male. Moreover, nearly a third of adolescent boys participate in unhealthy weight control techniques, like skipping meals, smoking cigarettes, vomiting or taking laxatives (National Association of Anorexia Nervosa and Associated Disorders). The American Psychological Association says males are less likely to seek treatment for an eating disorder due to the perception that it is a disease that only affects women, but the shameful secret isn’t just a girl thing.

Issues with eating and problematic concern over weight usually begin during adolescence or young adulthood. According to Joy Crabtree, PsyD., a psychologist at Cook Children’s, “This is typically a higher time of stress in general, and also a time when bodies are changing quickly or rapidly; this creates more discomfort with their self-image. Additionally, sometimes males are involved in sports where there is a focus on either gaining or losing weight, which can contribute to eating challenges as well.” Crabtree notes that eating disorders tend to occur among those who have perfectionist tendencies. “Increased stress can be a contributor, as well as unreasonable goals or ideals for meeting or maintaining a certain weight in order to participate in certain sports,” she observes.

To tackle the issue, Crabtree says schools should make their staff aware that males can suffer from eating disorders in addition to female students. Coaches and athletic personnel should be careful not to set unrealistic standards for their athletes and reach out to students and their parents if they see unhealthy patterns developing. In the meantime, though, the responsibility to identify problematic concern over weight or an unhealthy relationship with food lies with a boy’s parents.

Parents need to remember that eating disorders can be even more problematic in young men due to their reluctance to come forward. Watch for boys who develop a focus on eating only “healthy” food, counting calories, step on the scale a little too frequently or exercise excessively. Crabtree recommends “ensuring your family has a healthy focus on body image in general without a frequent or specific focus on weight, food intake, calorie counting etc. Try to stress balance in food intake and activity or exercise for overall health.” In addition, get input from your primary care physician regarding whether your child is in the average weight/height range or needs to focus more on eating a more balanced diet.

For boys diagnosed with an eating disorder, the treatment approach would not necessarily be different than it would for a girl. Crabtree stresses, however, that “the clinician must be aware and sensitive to the fact that they may be more avoidant or resistant to treatment in general, as well as less inclined to be open or honest about the issue as it is not as frequently seen as a male issue or concern.” Parents can help their teenaged boys to gain perspective on what is typical or average and what is extreme and unhealthy. Just as with young girls, it is important to stress that the celebrities they see on television or in the media are not typically “average” bodies. Parents can’t change societal pressures, but they can foster healthy behaviors and a realistic outlook on body image within their own households.

About the author

Natalie Raymond is an associate marketing specialist at Cook Children’s. She graduated from Texas Christian University with a Master of Science in journalism and certificate in business in 2014, and has a background in strategic communication and health care communication. Natalie enjoys doing her part to help our patient families stay healthy and spends her spare time with her eight furry friends (also known as pets).

The frightening footage of this type of violence at a school is difficult to watch for even the most hardened adult. So how do you talk to your child about catastrophes such as this? 

Joy Crabtree, Psy.D, a licensed psychologist for Cook Children’s Behavioral Health in Southlake, said parents must set the example for their children to follow. Dr. Crabtree encourages a discussion of the events, but only if their young children have learned about the incident elsewhere. If they haven’t heard about it, don’t share information with them. If they already know about it, answer their questions and most importantly, reassure them.

Crabtree said that in the cases such as today or recent school shootings in the news, parents need to think through whether their child can handle any news about it at all. Depending on their age and maturity level, it might be best to shield children from the news entirely.

“Since we are talking about a violence issue, and graphic violence that was targeted toward children, I don’t know that kids, certainly elementary age children, need to see any news or footage about it at all,” Crabtree said. “Students  were involved and that makes it even more difficult for them to process. Many children may be very frightened by this news and be scared something similar could happen at their own school. If they have heard about it, take as much time as needed to sit down with them and have a discussion/answer session, providing reassurance and support.”

For older children, such as middle school and high school, Crabtree encourages parents to again determine if their child is mature enough to handle the information.  If parents feel they can handle it, use the DVR or TiVo as your friend during the news. Watch it with your child and pause the TV to answer questions. Gauge your child’s emotions and turn the TV off if your child becomes too emotional or the news is too intense.

“Parents have to stay calm and cannot be glued to the TV,” Crabtree said. “If you have an elementary-aged child, and they haven’t learned the news, there’s certainly no reason to sit down with them and show them the story. There’s no need to cause fear in your children. By the time children are 7 or 8 years old, they can distinguish fact from fiction and will understand the consequences of what they are watching. Answer their questions, but only their questions. There’s no need to add more information that may scare them even more.”

Children may not understand the distance of the events on TV, make sure to calm their fears and let them know they are safe. If they continue to be fearful of their own safety, it may be helpful to get out a map and show them how far away they are from the incident that happened today.

“This news can be very scary to many children,” said Crabtree. “Parents need to realize this can really raise anxiety levels. They may feel that if it can happen there, it can happen anywhere. I can’t stress enough the importance of just being there for your child right now to support them.  Again, for younger children, only discuss it if they are already aware of the situation.”

Teens may have more questions and concerns because they can find information on the Web and discuss it with their friends at school. They may wonder why something like this happens. Share with your child your own fears and anxieties about the events. Let them know it’s Ok to feel scared or frustrated, but it cannot overtake them. Also, share with them ways that they may help by donating monetarily or giving blood in some instances. Sometimes when tragedy happens it helps them to work through their anxiety by becoming active and helping others.

Listen to your teen, or older child, regarding their fears and concerns. How an adult manages their own feelings can also provide a positive example for them.

Crabtree advises parents to watch to see if their children restrict activity, for instance if they don’t want to go to school or to the playground because it is too far away from home, or simply because they are afraid. Also notice if your child becomes withdrawn or more clingy than usual, and constantly wants to sleep in your bed.

“It is common for children to have a general fear, but if you see an overwhelming fear, it’s important to talk to their pediatrician,” Crabtree said. “If it continues to be a concern, then it may be time to get professional help.”